NPI: 1144844770 · VICTOR, NY 14564 · Pediatric Dentist · NPI assigned 05/29/2020
| Year | Claims | Total Paid |
|---|---|---|
| 2023 | 230 | $7K |
| 2024 | 647 | $20K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| D1120 | Prophylaxis - child | 223 | 223 | $9K |
| D0120 | Periodic oral evaluation - established patient | 243 | 243 | $7K |
| D1206 | Topical application of fluoride varnish | 232 | 232 | $7K |
| D0272 | Bitewings - two radiographic images | 134 | 134 | $2K |
| D2392 | Resin-based composite - two surfaces, posterior, primary or permanent | 20 | 13 | $2K |
| D1208 | Topical application of fluoride, excluding varnish | 13 | 13 | $198.38 |
| D0220 | Intraoral - periapical first radiographic image | 12 | 12 | $161.07 |